Trump's actions trigger health premium hikes for 2018

The study, from the Kaiser Family Foundation, looked at plans offered in 20 different states and in Washington D.C. The rates the study considers are requests and can be adjusted by regulators, but fewer insurers have even agreed to participate in the Obamacare exchanges in 2018. Insurers in those states have until September 27 to sign final contracts to participate in the exchanges next year. Since insurers often don't serve an entire state, KFF notes, the number of choices available to consumers in any given area will likely be lower than the average it calculated.

However, the analysis finds that preliminary rates will likely change, and some insurers have included additional rate increases or said they may revise their requests, depending on potential resolution of outstanding questions in federal policy. There is still time for the administration to announce a solid commitment to funding the CSRs and to enforcing the individual mandate. The mandate - which requires almost all Americans get coverage or pay a penalty - is key to encouraging younger and healthier consumers to enroll. They are also at the center of a court battle between the House and the Trump administration, which inherited the lawsuit from the Obama administration.

Those factoring in the uncertainties directly added an additional 1.2-20% increase to their rates to account for the end of individual mandate, and a 2-23% additional rate hike to account for the end of CSR payments.

Most insurers reacted to this uncertainty in one of two ways: They either factored them directly into their initial rate requests, or noted in their filings that they'd raise their rates-or exit the marketplaces-if either the mandate isn't enforced or the CSR payments aren't made.

Trump himself has stoked the uncertainty, continuing to call for Senate Republicans to go back to the drawing board on how to repeal and replace the Affordable Care Act in recent days, despite Senate Majority Leader Mitch McConnell (R-KY) having said it's "time to move on". Premium increases in unsubsidized second-lowest cost silver plans in the surveyed cities varied from a 5 percent decrease in Providence, Rhode Island, to a 49 percent increase in Wilmington, Delaware, with most cities experiencing premium increases below 25 percent. It's this group that will bear the brunt of these proposed premium increases, should they go into effect.

However, about 6.7 million people who buy coverage in the individual market could be hit by these premium spikes since they don't qualify for federal subsidies, according to a separate Kaiser analysis, which first appeared in Axios Thursday. 156 million people receive coverage through their employer, and 74 million are covered by Medicaid and the children's health insurance program.